Blood Sugar - what levels are harmful?

phil1966

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For the first 6 months after I was diagnosed, I stuck rigidly to a very strict LCHF regime which brought me brilliant blood sugar levels (under 5 in a morning and rarely over 5.5 at any time), along with losing a lot of weight.

However, once I reached my target weight, I found I can't eat enough calories on LCHF to stop my weight loss (basically I get full very easily on LCHF and can't eat more than 1,500 calories without feeling uncomfortably so: What paid dividends during my weight loss was now hampering my efforts to maintain my weight!), so I've been experimenting with introducing carbs into my diet.

This has inevitably led to increased blood sugar levels so I'm now trying to establish whether my current blood sugar readings are likely to lead to problems for me down the line or whether I'm over-worrying

As a test, I tried this morning with a particularly "carby" breakfast - a bowl of nut-free muesli (40g Carbs with 9g of sugars) which resulted in the following readings:

Before: 5.1
45 minutes after: 9.0
75 minutes after: 8.7
120 minutes after: 6.4
180 minutes after: 4.8
240 minutes after: 4.7

The concerns for me are the readings between 45 and 120 minutes where the spike to 9.0 is pretty dramatic and even though I dropped down after 2 hours and right down after 3, are the spikes early on enough to cause long term damage and what sort of 1 hour figure should I be aiming at? (I see a similar pattern of a pretty high spike above 7 with pretty much any carbs, but less than this if I have less carbs, obviously)
 
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Hairycamel

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I asked my doctor the exact same question last week as I have the same issues. She has been very good throughout my diabetic journey so far and I value her opinion. All she was bothered about that levels were not elevated at 2 hours and beyond. I specifically mentioned going to 8 and 9 after some foods but again, she said as long as it's down at 2 and 3 hours. Hope that's of some comfort to you.
 
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DeejayR

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I'll be interested in this, although sorry you're the guinea pig. I'm also underweight, by about 3kg, and it's not going back on with my customary diet. I do eat a lot, probably more protein than I should.
Today my breakfast was a heaped tbsp of whole grain oats soaked overnight in hot water in a thermos with cinnamon, then heated up with chia seeds, a sprinkling of flax, a bit of xylitol and a couple of teaspoons each of butter and coconut oil. Before 5.3, 1hr 5.0, 2hr 5.6, 3hr 5.2. This way of eating grains has always worked for me. If I'm introducing borderline food into a meal (eg, carrot, peas, sweetcorn) I make sure there's plenty of fat as well, hopefully to spread the flow and avoid a big rise. Could you try similar?
I don't want to go above 7.5 and even 7 is a disappointment. I don't know where damage begins and I don't want to find out.
 
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phil1966

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Thanks both for the replies. @DeejayR - that sounds like a good suggestion: I'll try mixing things up a bit and introducing more fat alongside the increased carbs
 
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DeejayR

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I may try the same thing if I can pluck up courage. Your daily diet you told us about not long ago is a great help to me in keeping things simple.
 
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hankjam

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I'm with you on all of this. I tend to eat like a horse, never feel full and either flat lining on weight or slowly still losing some... 3 kg in the last 5 months.. I too probably eat too much protein.... meat and lots of veg..... so having at least one avocado a day for it's fat content... and I like them with olives and garlic and a bunch of olive oil... I've reduced my testing to just morning and pre and post evening meal, where most of my carbs are... and they are only what's in my meat and loads of green veg.
Going to watch your post with interest.
Cheers
Hj
 
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Robbity

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AS far as I know it's the two hour level that you perhaps should be watching as I believe everyone diabetic or not has some sort of earlier (1 hour) spike. if you have a potter through old threads, I'm sure there are some where people have tested their non-diabetic relatives' 1 hour post meal spikes and these have often been quite high! :wideyed:

The NICE guidelines on the UK diabetes main site just specify that for 2 hours after meal levels should be:
  • non diabetics: under 7.8mmol/L
  • type 2s: under 8.5
  • type 1s: under 9.0
I've always aimed for and generally manage to stay under the 7.8 non diabetic mark, though pre meals and fasting levels aren't so good for me.

Have you thought about just eating extra fats without the carbs - which should keep your levels lower, and weight OK, as it's the carbs that are (now) supposed to be the "weight-putter-onners ".

Robbity
 
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phil1966

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Have you thought about just eating extra fats without the carbs - which should keep your levels lower, and weight OK, as it's the carbs that are (now) supposed to be the "weight-putter-onners ".

Robbity

I did try that but still lost 1kg in less than a week on LCHF - the problem I have is that I can't eat more than about 1500 calories a day on LCHF because I feel full all the time and that intake isn't enough to stop me losing weight. I'm very active now (play football and squash several times a week, regular lengthy walks with the dogs and I've also taken up jogging) and according to My Fitness Pal I should be eating nearly 3,000 calories a day. I can't see any way on earth I can eat that much food so I've set myself a target for now of 2,000 calories a day and see where that takes me.

My "experiment" is to introduce some carbs so that I can eat more (or the carbs compensate for the weight loss due to reduced calories), but I want to do it in such a way that it doesn't adversely affect my blood sugar :)
 
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phoenix

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I did try that but still lost 1kg in less than a week on LCHF - the problem I have is that I can't eat more than about 1500 calories a day on LCHF because I feel full all the time and that intake isn't enough to stop me losing weight. I'm very active now (play football and squash several times a week, regular lengthy walks with the dogs and I've also taken up jogging) and according to My Fitness Pal I should be eating nearly 3,000 calories a day. I can't see any way on earth I can eat that much food so I've set myself a target for now of 2,000 calories a day and see where that takes me.

My "experiment" is to introduce some carbs so that I can eat more (or the carbs compensate for the weight loss due to reduced calories), but I want to do it in such a way that it doesn't adversely affect my blood sugar :)
Phil, I'm not T2 and definitely not a low carber but I saw your menu for a day in another thread. Could you introduce more vegetables and even some berries into your diet? You could try legumes that are very much higher in carbs but low on the glycemic index
see for example
http://www.mendosa.com/chanadal.html
 
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Lamont D

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Even with my condition, the spike, was not worrying my consultant until I went into ketosis. As long as it returns to within 2mmols after 2 hours, then it won't cause the damaging conditions you are referring to.
It's the continuous high levels of blood glucose, that generally do the damage.
Once, you are in control and get your fasting levels as close to normal as you can, then, you will feel better and healthier. Then you can allow the odd higher spike and higher 2 hour level. Control is the key to unlock your health.
The 2 hour reading can be used as an tool so that you can decide what's good and what's bad in your diet.
The reason it is 2 hours as it the common denominator in all patients that your blood glucose levels are coming back to normal. A good majority of diabetic and non diabetics have the same drop level at 2 hours. It is a very good indicator of what's happening in your blood glucose levels.
The same as the fasting hba1c level is a good indicator of how high your levels are over a longer period and for diagnosis.
 
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diamondnostril

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Insulin
For the first 6 months after I was diagnosed, I stuck rigidly to a very strict LCHF regime which brought me brilliant blood sugar levels (under 5 in a morning and rarely over 5.5 at any time), along with losing a lot of weight.

However, once I reached my target weight, I found I can't eat enough calories on LCHF to stop my weight loss (basically I get full very easily on LCHF and can't eat more than 1,500 calories without feeling uncomfortably so: What paid dividends during my weight loss was now hampering my efforts to maintain my weight!), so I've been experimenting with introducing carbs into my diet.

This has inevitably led to increased blood sugar levels so I'm now trying to establish whether my current blood sugar readings are likely to lead to problems for me down the line or whether I'm over-worrying

As a test, I tried this morning with a particularly "carby" breakfast - a bowl of nut-free muesli (40g Carbs with 9g of sugars) which resulted in the following readings:

Before: 5.1
45 minutes after: 9.0
75 minutes after: 8.7
120 minutes after: 6.4
180 minutes after: 4.8
240 minutes after: 4.7

The concerns for me are the readings between 45 and 120 minutes where the spike to 9.0 is pretty dramatic and even though I dropped down after 2 hours and right down after 3, are the spikes early on enough to cause long term damage and what sort of 1 hour figure should I be aiming at? (I see a similar pattern of a pretty high spike above 7 with pretty much any carbs, but less than this if I have less carbs, obviously)

Hi Phil,

I had the same problem when I moved to a Ketogenic (LCHF) diet a couple of years ago. My blood-sugars finally were under my control (for the first time ever) and so I wanted to stick with the diet. But obviously I needed to stop the weight loss. I did not want to add another meal to my routine, because that would inevitably introduce more Carbs and Protein, and I didn't have the hunger for it anyway.

The solution I found was to drink my calories, rather than eat them. I started to add a dollop of coconut oil into my coffees, which over 2 or 3 daily coffees easily added more than 500 kCal to my daily intake. This stopped the weight loss, without making even a smidge of difference to my blood-sugar levels.

Now that I have discovered Bulletproof coffee, it's easy to drink much more kCal than that. And now that I have moved back to the UK, where pourable double cream (50% FAT) is available everywhere, it's become even easier.

I've continued with my regular LCHF strategy (1 meal per day, which normally comes in at something like 1,200 - 1,500 kCal) and the rest of my kCal I take as FAT in drinks. Has worked well for me, to solve this thorny problem. Have maintained my weight and good levels for couple of years now, and feel (physically and mentally) very good.

Regards :)
Antony
 
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Ian DP

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There is some (conflicting) evidence where any BG level above 7.8 at any time kills our insulin making beta cells. Dr Bernstein recommends keeping under 5.6 two hours after fasting, to help preserve beta cells.

I am on a LCHF diet and eat 3,000 calories per day, to maintain weight (6'-2", BMI of 22).

Just over a year ago my BMI dropped to 21, since then I have increased my fat / calorie intake, mainly through:-
A bullet proof coffee of 30g butter, 30g coconut oil and a spoon of double cream (around 500 calories).
A pint of guiness (around 400 calories).
Most days I will have a steak or chops, always eggs and bacon for breakfast.

Edited to add that I posted before reading Anthony's post. I also have lots of double cream (around 100ml per day). I didn't like cream a few years back, thought it sickly (and full fat milk), but you get used to it, and now I love it.
 
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phil1966

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Thanks for the replies everyone. I've seen a couple of suggestions for bulletproof coffee but I honestly couldn't stomach the thought of it - I like my coffee black now and even the thought of that much fat floating around in my coffee makes my stomach turn (plus it would probably fill me for a whole day ;))

Having looked back through my food diary, I think my biggest issue is simply that I don't really have much of an appetite any more: I'm sat here very full and not wanting to eat anything else and I've only had 1,518 calories with the following macros breakdown
Carbs: 83g
Fats: 74g (22g saturated)
Protein: 112g

Included in that is a cooked meal with celariac, cauliflower and beans, my "experimental" muesli and a tuna sandwich. I've also added snacks on some seeds (can't eat nuts as I'm allergic) and 90% chocolate but that's about my limit.

So, even increasing my carbs hasn't really helped me increase my calories so I may as well go back to LCHF and at least keep my BS fully under control :)

Edit to add: I've just had a thought that maybe it's the metformin I'm still on that's suppressing my appetite? If that's a possibility I'll go and have a chat with the doctor
 
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phil1966

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661
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Type 2
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Just as an update to this thread, I now seem to have found a diet that is good for both my weight and blood sugars and they are again staying stable throughout the day (not as low as on LCHF but back in the 5s after 2 hours and not above 7.8 after an hour) and my weight this morning was exactly the same as last week

The carbs I found I can and can't add are as below (keeping the total below 150g a day)

can eat
Burgen Soya and Linseed Bread (no more than 2 slices a day)
Seeds (don't seem to affect me at all BS wise)
Bananas (small, no more than one a day) - this one surprised me!
Sweetcorn (no more than 20g at a time)
Oatibix with full fat milk (the most surprising one - pushes my BS to around 7.6 on the hour, but down to starting point after 2 hours)
Larger amounts of Strawberries and Raspberries (up to 50g in a serving)
Small amount of 90% Cocoa chocolate
Small amount of brown rice OR a single wholemeal chapatti with a hot curry (homemade)

can't eat
Pizza (no surprise there!)
Potatoes (Mashed, boiled, roasted or fried makes no difference: hammers my BS level)
White bread (again, no surprise)
white rice (ditto!)
any indian bread apart from the above mentioned chapatti


In addition, I'm not eating any supper and keeping carbs after early evening to a minimum: Basically, I get them by having oatibix for breakfast and 2 slices of burgen bread as a sandwich at lunchtime with a cooked meal at night with loads of fresh vegetables

Doing that seems to have stabilised by blood and my weight. Of course, what works for me might not work for everyone (and it certainly wouldn't have worked for me 6 months ago!)
 
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mikej1973

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There are studies suggesting all sorts of levels are safe or unsafe. I aim for below 7.8 most of the time and always under 8.5. After 2 hours I'll know in 10 or 20 years whether I'm being too cavalier!
 
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Lamont D

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For me, I have a very similar diet, except for the bottom item. I can't have wholemeal anything or rice!
If I have a curry,(not hot!), yes homemade, but only the curry and meat with a salad, that's it, the only bread is two pieces of Bergen bread, spread around the day.
I always keep in my comfort zone. Between 4 and 6 mmols. Regardless of when I test, I need to keep in control.
My supper is my yoghurt and chocolate.
It is very hard to eat and low carb as often as I do, during the day.
There is as no one has mentioned, plate size, it is so important for my control.


Read my new blog.
 
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hankjam

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<snipped>


In addition, I'm not eating any supper and keeping carbs after early evening to a minimum: Basically, I get them by having oatibix for breakfast and 2 slices of burgen bread as a sandwich at lunchtime with a cooked meal at night with loads of fresh vegetables

Doing that seems to have stabilised by blood and my weight. Of course, what works for me might not work for everyone (and it certainly wouldn't have worked for me 6 months ago!)[/QUOTE]
Hi Phil

I feel as if I am stalking you....
I managed to add a 0.5 kg this week, though I'm really not sure if it my water status really... I don't eat any bread, potatoes or cereals, will eat some pasta and brown rice and my BG's have gone up 0.5 but are nearly always less than 6.0, which I have conditionally formatted on my sheets.
During the day I am beginning to experience a hunger I haven't noticed in a long time... and even after eating substantial amounts, don't feel full...
Tonight I tried that cooking/cooling/reheating spag for Bolog and there does seem to be something there for me..
Avocado, garlic and olive oil at least once a day... just love 'em.
I feel as if I'm eating loads, portion control has gone out the window and I still feel I lacking calories.... it's all a bit odd without those carbs....
 
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chris270181

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Interesting read I was planning on asking the same as I've been doing a similar experiment to see which foods do what to my levels .

I've found a couple of 1 hour test quiet high ie a 3 to 4 mmol rise but always back in range at 2 hours.
 

mikej1973

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Type 2
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I ignore the one hour spike. Its something non diabetics experience too I eat 3 times a day. If I do snack it will be fruit or low carb. I'm OK with my sugar being high for a few short hours.

I think the trick is to make your decision as to what is ok in terms of a spike and see what happens. I suspect new research will come out before we ever find out how reliable the old research was!
 
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Totto

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When my glucose metabolism still worked as it should I never seemed to go above 5 at any time. When my diabetic friend was at 15-20 after a meal I'd be at 4.7. Normal normal people rarely seem to get a rise of more than 1 or possibly 2 mml and that only for a very short time.

Have a look at this site: http://www.phlaunt.com/diabetes/index.php